Individual
DR. RYAN JOHN WISE
Active
Individual
DR. RYAN JOHN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
2018-00378
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13979212
CAQH
—
05
—
1932542842
—
NC
01
—
19WTP
BCBS
NC
01
—
5817994
ENVOLVE
NC
01
—
A34493
EYEMED
NC
Enumeration date
04/10/2013
Last updated
08/20/2025
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